Fora Dermatology PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

FORA DERMATOLOGY PLLC

Practice address

118 Gateway Blvd Ste a
Mooresville, NC 28117-6542

Phone

(704) 230-1302

Fax

(704) 230-1284

NPI assigned

Oct 31, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bishr Al Dabagh, MDNPI 1154565661

Title

Owner

Phone

(704) 230-1302

Specialties & licenses 3

Addresses

Other names 1

• PC Dermatology PLLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bishr Al Dabagh, MD

  • MOHS-Micrographic Surgery Physician
  • Mooresville, NC
  • NPI 1154565661

  Dermatology, NC

  Medicare reassignment Care Compare group NPD Authorized official
• Lina Sihamath Ricks, PA-C

  • Physician Assistant
  • Mooresville, NC
  • NPI 1881584381

  NC

  Medicare reassignment Care Compare group NPD
• Mary Elizabeth Weaver Corey, PA-C

  • Physician Assistant
  • Mooresville, NC
  • NPI 1699197467

  NC

  Medicare reassignment Care Compare group
• Monnie Jordan Drummond, PA-C

  • Physician Assistant
  • Matthews, NC
  • NPI 1760260681

  NC

  Medicare reassignment Care Compare group
• Kimberly Sumner Messina, PA-C

  • Medical Physician Assistant
  • Mooresville, NC
  • NPI 1225702871

  NC

  Medicare reassignment Care Compare group
• Garyn Scout Schmidt, PA-C

  • Physician Assistant
  • Mooresville, NC
  • NPI 1619738689

  NC

  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685836800000",
    "number": "1366086597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 GATEWAY BLVD STE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176542",
            "telephone_number": "704-230-1302",
            "fax_number": "704-230-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 GATEWAY BLVD STE A",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176542",
            "telephone_number": "704-230-1302",
            "fax_number": "704-230-1284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "128 Medical Park Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178579",
            "country_code": "US",
            "telephone_number": "704-230-1302",
            "fax_number": "704-230-1284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FORA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2023-06-04",
        "certification_date": "2023-06-04",
        "status": "A",
        "authorized_official_last_name": "AL DABAGH",
        "authorized_official_first_name": "BISHR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-230-1302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PC Dermatology PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Chrissy Gayle Fohr, NP-C
• Steven G Folstad, M.D.
• Food As Medicine LLC
• Foot and Ankle Specialists of the Mid-Atlantic, LLC
• Christopher Foote, LCSW
• Lauren Aprile Forbis, M.S.CCC-SLP
• Madison Ford, SLP
• Pauline Ford, LCSW
• Ruby Ann Ford, MS, CCC-SLP
• Mistee Laro Formica, CNM

• All providers in Mooresville, NC
• MOHS-Micrographic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.